Residual Deformities of the Hip

Residual hip deformities in the pediatric population present complex and challenging problems for the orthopedic surgeon. Successful treatment requires an appreciation of multiplanar deformities specific to the hip joint such as coxa breva, coxa magna, femoral retroversion, and acetabular dysplasia. This chapter focuses on age-specific treatment strategies for addressing residual hip deformities and their underlying etiologies such as developmental dysplasia of the hip, slipped capital femoral epiphysis, and Perthes disease. Indications and detailed operative technique are described for six surgical procedures such as: (1) triple pelvic osteotomy, (2) modified Dunn procedure (with surgical hip dislocation), (3) modified Southwick intertrochanteric osteotomy, (4) Morscher femoral neck lengthening osteotomy, (5) femoral head reduction osteotomy, and (6) hip distraction with a hinged external fixator. Operative techniques for treating acquired pediatric hip disorders continue to evolve in the pursuit of optimizing long-term outcomes. This chapter presents to readers modern and innovative surgical approaches to address complex pediatric hip deformity.